自体角膜缘上皮移植治疗眼表疾病

目的 评估角膜缘上皮移植治疗眼表疾病的疗效。方法 对59例患者(眼部化学伤9例、热烧伤2例、初发翼状胬肉36例、复发翼状胬肉12例)采用自体角膜缘上皮移植进行治疗，并对其疗效进行评估。结果 11例烧伤(化学伤和热烧伤)中9例一次手术成功，另2例二次手术后治愈。所有翼状胬肉患者术后2周角膜表面光滑透明。术后随访3～12个月。结论 自体角膜缘上皮移植治疗眼表疾病是一种方便、安全和有效的方法。     

眼部化学性伤45例统计分析(摘要)

眼部化学伤是较常见的眼外伤。本文通过对45例不同物质所致的眼化学伤的统计分析.提示碱性伤占大多数。对结膜的损害以炎性症状为主:如结膜充血.水肿等,严重者可形成假膜。对角膜的损害主要为角膜上皮的点状脱落。治疗:局部及时彻底地冲洗为治疗的关键;另外应大量补给VitC,VitAD等;局部或全身应用抗生素:必要时应用激素及其它一些治疗方法。如果能正确、及时地得到处理,一般预后良好。     

硫酸二甲酯对眼的急性毒作用8例报告

于1991年8月11日收治8例急性硫酸二甲酯中毒患者中,均出现眼部损害,现报告如下: 临床资料1.患者均为男性。年龄22～38岁,平均33.4岁。工种均为化工厂工人。     

鱼舱内鳀鱼腐败气体中毒的眼部表现

目的研究渔民在鱼舱内作业因鳀鱼腐败后产生有害气体中毒时，眼部临床表现及其分型。方法观察256例鳀鱼腐败气体中毒患者结膜、角膜、房水及虹膜的临床表现。结果所有患者出现结膜充血、水肿、粘液样分泌物等结膜炎的表现。106例（41．41％）出现角膜上皮点状浸润或大片状上皮剥脱；53例（20．70％）在出现角膜损害的同时，房水呈粉尘状浑浊。结论鳀鱼腐败气体中毒后，眼部病变可分为结膜损害型、角膜损害型、葡萄膜损害型3种。     

结膜角膜移植治疗早期重度眼化学伤

重度眼化学伤对组织损伤重、病期长、致盲率高,眼表结构蒙受严重损害。临床应用尸体结角膜移植治疗早期重度眼化学伤17例(19眼),现将结果报告如下:资料与方法一、病例选择:重度眼化学伤17例(19眼),男14例,女3例,年龄17～52岁,平均285岁。眼化学伤包括硷烧伤11眼,酸烧伤8眼...     

急性亚硝酸钠中毒眼部改变附52例分析

本文对我院收治的52例急性亚硝酸钠中毒患者的眼部表现作了描述。一过性黑朦11例;一过性视力下降34例;上险下垂7例:眼外展受限14例;集合力减弱12例。视网膜静脉迂曲怒张38例,视乳头充血40例。视乳头水肿8例。对眼部改变有关的因素作了初步分析,对急性亚硝酸钠致眼部改变发生机理进行了初步讨论。     

急性氯气中毒眼部并发症的临床研究

目的：观察急性氯气中毒患者眼部并发症的发生情况。

方法：回顾性分析2009-02/2013-02就诊于临沂市人民医院的急性氯气中毒患者121例,其发生眼部刺激症状、干眼及其它一些眼部并发症的情况。

结果：在121例患者中,有117例(96.7%)并发有眼部刺激症状及角结膜上皮的损伤,随着氯气中毒程度的加重,眼表损伤也加重。在115例随访患者中,出院3,6mo后分别有32,7例患者存在干眼。1例轻度氯气中毒患者在激素治疗肺部并发症过程中并发泡状视网膜脱离,经停用激素和加用促进液体吸收药物治疗后,症状及体征逐渐好转。1例重度氯气中毒伴有昏迷患者在治疗过程中出现角膜溃疡,药物+结膜瓣遮盖术溃疡愈合,但留下永久性角膜白斑。

结论：急性氯气中毒会导致角结膜上皮损伤及干眼发生,在激素治疗过程中要警惕与激素应用相关的眼部并发症,比如泡状视网膜脱离。对于一些重度中毒的患者,在抢救生命治疗中,重视眼部角结膜上皮损伤的治疗,以免造成不可挽回的后果。     

食品干燥剂致儿童眼部化学伤的临床观察

目的观察食品干燥剂致儿童眼部化学伤的临床表现及疗效。方法食品干燥剂致儿童眼部化学伤9例（15眼）。其中Ⅰ度2眼，Ⅱ度7眼，Ⅲ度5眼，Ⅳ度1眼，治疗采用大量中和液反复冲洗、联合10％维生素C及碱性成纤维细胞生长因子滴眼、维生素C结膜卜注射及全身应用、散瞳及抗感染等综合治疗。结果本组9例（15眼）中，1例（1眼）出现角膜溃疡、严重葡萄膜炎症反应，2例（2眼）角膜上皮愈合而未遗留瘢痕，6例（12眼）有不同程度的角膜浑浊（薄翳或斑翳）。结论此种食品干燥剂致眼部化学伤为碱烧伤。碱性化学物质穿透力强，导致组织坏死广泛深入，后果严重。应进行综合治疗，强调预防为主，重视急救知识的普及。     

103例急性萘中毒的眼部表现

１０３例急性萘中毒的眼部表现罗建国１９９５年５月，娄底市某中学因意外事故造成数百名师生萘中毒，二百余名中毒患者在我医院治疗，其中１０３例有眼部损害，现报告如下。资料与方法１０３例患者有眼部损害，均经环保局、卫生防疫站职业病防治所鉴定为萘中毒，其中男性...     

硫酸二甲酯眼损伤的临床表现及治疗

对我们所遇８例硫酸二甲酯眼部中毒的临床表现及治疗进行分析讨论。眼部中毒主要为酸性烧伤、角膜损害,常同时合并呼吸道症状,重者可合并肝肾损害。治疗以硷性溶液冲洗结膜囊及局部对症为主。     

眼球破裂伤手术治疗临床观察

目的:探讨眼球破裂伤一期手术处理的方法、原则,观察术后临床效果,为临床提供理论依据。方法:对21例21眼严重眼球破裂伤患者全部实施显微手术缝合,达到完全水密性。结果:所选21例经一期手术缝合的眼球破裂伤患者,术后经3mo～2a的随访,除1例在外院做眼球摘除外,均保持正常的眼球形状,不仅使眼球得到了保留,而且经过二期玻璃体切除手术后视力也得到不同程度的提高。结论:严重的眼球破裂伤经精心的显微手术修复,绝大部分可以保住眼球;部分患者有望恢复一定视功能;对于严重的眼球破裂伤不要轻易摘除眼球。     

眼外伤所致继发性青光眼临床分析

目的:探讨眼外伤的发生、治疗、转归以及眼外伤继发青光眼的发生、治疗及预后。方法:对305例眼外伤患者的致病因素、外伤部位、外伤类型进行分析,并对眼外伤患者进行随访,分析眼外伤继发青光眼的发生率。通过对眼外伤继发青光眼的药物及手术治疗,分析继发性青光眼的预后。结果:眼外伤部位、类型与眼外伤个体病因有关,病因以异物致伤最常见,外伤类型以角膜、巩膜穿孔伤最常见;眼外伤患者经治疗后视力均有不同程度的好转;眼外伤治疗后继发性青光眼的发生率高(10.82%),经药物和手术治疗,患者眼压均有不同程度的下降。结论:眼外伤病因、类型多样,应根据患者情况进行个体化治疗。对于存在易引起眼外伤的职业应该加强职业保护,做好眼防护。眼外伤治疗后继发性青光眼的发生率高,应尽早检查诊治以减少远期视力损害。     

机械性眼外伤300例视力预后多因素分析

目的:通过对我院300例住院治疗的机械性眼外伤患者病历资料进行统计与回顾性分析,探讨机械性眼外伤患者急诊处理后的视力预后影响因素。方法:对300例机械性眼外伤患者的一般情况、眼别、受伤原因、急诊处理方式、入院视力、出院视力等进行记录和统计分析。结果:机械性眼外伤300例,男女比例约为8∶1,15～20岁年龄段男女比例最高,约为14∶1,发病高峰年龄在35～45岁和5～10岁。以眼球开放性外伤、眼和附属器挫伤最多见。在眼球开放性外伤中,以异物伤最多见。致伤原因以钝器伤、锐器伤为主,爆炸伤等原因较为少见。机械性眼外伤300例311眼的治疗方式中以眼内异物取出为主,其次为保守治疗,视力预后的主要影响因素是:致伤原因、是否伤后24h内处理。急诊等处理后,出院视力的提高具有显著性(P<0.05)。结论:机械性眼外伤300例致伤原因以钝器伤、锐器伤和爆炸伤最为常见。住院治疗的机械性眼外伤视力预后的主要影响因素是:致伤原因、是否伤后24h内急诊处理。     

新鲜羊膜移植治疗难治性眼表疾病的临床观察

目的:探讨新鲜羊膜移植治疗难治性眼表疾病的疗效。方法:选择碱烧伤患者4例、角膜溃疡患者10例,共14例。采用单层羊膜移植,术后随访6～12mo。结果:14例术后临床上未见新鲜羊膜植片急性排斥反应;同时眼表迅速稳定。碱烧伤4例无角膜进行性溶解和穿孔,10例角膜溃疡患者中8例溃疡愈合,视力不同程度提高。结论:新鲜羊膜移植是重建眼表的有效方法,它可以减轻角膜的炎症反应,阻止角膜进行性溶解,加速眼表稳定,减少角膜新生血管的形成,为Ⅱ期角膜移植赢得宝贵时间,创造良好基础。     

羊膜移植治疗眼表烧伤的临床应用分析

目的:评价羊膜移植治疗眼表化学烧伤及热烧伤的临床疗效。方法:收集我院眼部化学及热烧伤24例28眼,行新鲜羊膜移植术治疗,随访6～24mo。术后观察视力,羊膜移植片情况,角膜恢复情况及角膜上皮修复时间,并发症。结果:术后视力提高者22眼(79%),不变者6眼(21%),无视力下降者,术前术后视力差别无统计学意义。羊膜移植片情况:28眼中羊膜覆盖成活24眼,成活率达86%。角膜恢复情况:28眼中角膜最终恢复透明8眼,角膜云翳12眼,角膜斑翳5眼,角膜白斑3眼。角膜上皮愈合时间:22眼角膜上皮1～3wk全部愈合。术前4眼睑球粘连患者,睑球粘连情况均得到改善,3眼完全分离。结论:新鲜羊膜移植术是治疗眼表化学及热烧伤的有效方法。     

前房穿刺及pH值测定在治疗中度眼碱烧伤中的应用

目的:探讨应用前房穿刺及pH值测定在治疗中度眼碱烧伤中的临床疗效。方法:中度眼碱烧伤患者78例,随机分为两组,试验组39例,应用前房穿刺冲洗,并测定房水pH值,结合常规综合治疗。对照组39例,仅应用常规综合治疗。观察两组患者角膜水肿消退时间、视力恢复情况、新生血管生长情况及其他并发症情况。结果:试验组与对照组角膜水肿消退时间、视力恢复情况、新生血管生长情况及其他并发症情况的比较,其差别具有统计学意义(P<0.05)。结论:前房穿刺及pH值测定在治疗中度碱烧伤中起着积极的作用。     

Amniotic membrane transplantation in acute chemical and thermal injury

PURPOSE: To present a case of chemical injury and a case of thermal injury treated by amniotic membrane transplantation in acute phase. METHODS: Case reports. An eye with sodium hydroxide injury, opaque cornea, and limbal ischemia of more than 180 degrees and an eye with hot tea injury, opaque cornea, stromal edema, and scarring were treated by amniotic membrane transplantation within the first few weeks of injury. RESULTS: In the eye with sodium hydroxide injury, 4 months after amniotic membrane transplantation, the ocular surface is stable, superficial corneal scarring with vascularization is present, and visual acuity is 20/25. In the eye with thermal injury, 6 months after amniotic membrane transplantation, the ocular surface is stable, but there is superficial scarring and vascularization, and visual acuity is 20/20. CONCLUSIONS: Amniotic membrane transplantation can be considered in chemical injury with severe limbal ischemia and in severe thermal injury in acute phase. Long-term studies are warranted to evaluate further the efficacy of amniotic membrane transplantation in these clinical situations.     

Limbal cell autograft transplantation for severe ocular surface disorders

· Background: Limbal cell transplantation may improve the visual outcome after chemical trauma and ocular surface diseases. · Methods: Nine eyes of nine consecutive patients (eight males and one female, age 9–60 years), underwent limbal autograft transplantation (LAUT). In five cases LAUT was done for severe chemical burns in the acute stage (group 1). In four patients with old chemical trauma LAUT was performed years after the trauma (group 2). Penetrating keratoplasty (PKP) was carried out within 6 months after LAUT in three patients of group 2. Preoperatively, the visual acuity in all the patients except one was counting fingers. Postoperatively, patients were treated with topical antibiotics, topical corticosteroids and oral steroids. Oral cyclosporin was used after penetrating keratoplasty. · Results: No complications were observed during the surgical procedure. Postoperatively, the epithelialization was complete between days 7 and 12. The inflammatory response subsided within 3 months and the stromal neovascularization decreased. Visual acuity improved in all the nine cases, ranging from 6/6 to 6/30. The decreased visual acuity was due to corneal haze, scars and vascularization. Following PKP, the three grafts remained clear with intact epithelium. No complications were observed during the follow-up period from 7 to 60 months. · Conclusions: Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity after severe chemical trauma. Received: 19 March 1997 Revised version received: 22 July 1997 Accepted: 29 September 1997     

改良前房穿刺术在急性闭角型青光眼持续高眼压中的应用

目的:探讨改良前房穿刺术处理急性闭角型青光眼持续高眼压状态下的疗效。方法:对33例33眼急性闭角型青光眼急性发作患者(术前眼压均>60mmHg)在应用常规降眼压药物治疗未能有效降低眼压后,采用改良前房穿刺术,放出房水。结果:所有患者经改良前房穿刺放液后高眼压及眼痛迅速缓解,视力有不同程度的提高,术后眼压平均为15mmHg,未发生与前房穿刺有关的并发症。结论:改良前房穿刺术处理急性闭角型青光眼持续高眼压,损伤小、反应轻、简便高效,可以避免长期大量应用降眼压药物引起的副作用,迅速降低眼压,可以缓解患者痛苦,减轻因高眼压造成的视功能损害。     

Correlation of varicella-zoster virus copies and final visual acuities of acute retinal necrosis syndrome

· Background: Herpes viruses may play an important role in acute retinal necrosis (ARN) syndrome, and raised antibody titer or virus genome have been detected in intraocular fluids of patients with ARN. In spite of aggressive anti-viral therapy, the clinical courses and final visual acuities among these patients have varied. Our purpose was to estimate the amount of virus and compare it to final visual acuity in patients with ARN. · Methods: The number of varicella-zoster virus copies in aqueous and vitreous before and after administration of anti-viral therapy were estimated by polymerase chain reaction (PCR) and by semi-nested PCR in 12 eyes of 11 patients with ARN and were compared with clinical characteristics. · Results: Viral genome DNA was amplified in ocular fluids diluted between 10⁻³ and 10⁻⁶ in patients whose final visual acuities were 0.3 or less. Conversely, the dilution required was between 10⁻¹ to 10⁻³ in the patients whose final visual acuities were 0.4 or better. The difference was statistically significant. Further, patients in the latter group reacted to the anti-viral drug acyclovir more promptly than did the former patients. · Conclusion: Our results showed that final visual acuity may partly depend on the number of virus copies in ocular fluids. The number of virus copies tended to be higher in elderly or immunocompromised patients than in others, and the treatment was less efficacious in these patients. Received: 26 November 1997 Revised version received: 24 February 1998 Accepted: 26 February 1998